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Vitamin B12 plays a vital role in red blood cell production, nerve function, and cellular energy

UK guidelines recommend monitoring clinical response and full blood count (typically at around 2 months) to ensure treatment adequacy, rather than routinely rechecking B12 levels after replacement has started

Nausea, somnolence, dizziness, constipation, and loss of appetite have been reported as common side effects of duloxetine and venlafaxine, but they are considered relatively safe drugs to use [46,49]

DSIP provides acute deep-sleep promotion when needed

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